This specification relates to a laser surgical apparatus having a multi-articulated arm and different types of surgical instruments to be used in surgery on both soft and hard tissue.
There have been known laser surgical apparatus for performing treatment by irradiating a part to be treated by a laser beam. For instance, a laser treatment apparatus which emits a carbon dioxide laser beam having infrared wavelengths has been used in plastic surgery treatments for removing wrinkles, birthmarks, etc. of patients.
In an apparatus of this type, the treatment beam emitted from a laser source is guided through a multi-articulated arm to a hand-piece mounted on an end of the arm and emerges therefrom to irradiate a treatment part. The arm is provided with a plurality of light delivery pipes and joints each jointing the pipes. In each joint, a reflection mirror is disposed. An operator manipulates the arm to position or put the hand-piece onto a target treatment part.
Sharon (U.S. Pat. No. 3,913,582) patented an apparatus for conducting a laser beam from a laser, through an articulated arm, to an output device, said apparatus being constructed so that the output device is easily maneuvered. In one embodiment, a beam from a laser mounted on an optical bench is directed to a first mirror that reflects the beam upward along the axis of a vertical shaft. At the top of the shaft, a second mirror, mounted on a conical bearing and rotatable about the axis of the vertical shaft, reflects the laser beam along the axis of a horizontal sleeve to a third mirror that is mounted on a sleeve bearing so that it is rotatable about the horizontal axis. In like fashion, the beam from the third mirror is successively incident on fourth, fifth, sixth, seventh, and eighth mirrors all of which are rotatable about the axis of the shaft down which the incident beam propagates. Finally, the beam from the eighth mirror enters the output device. The second through eighth mirrors are all mounted in the articulated arm and are interconnected by sleeve bearings and, in some cases, hollow tubes. The arm is supported by a counterbalancing system that is connected to the arm at a point between the third and fourth mirrors.
If treatment needs to be performed on a wide range, for instance, the arm may not be long enough to reach a target treatment part. In this case, the operator needs to move a main unit of the apparatus until the hand-piece can reach the treatment part. This work would be troublesome to the operator and cause a delay in treatment. If a fixed total length of the arm is made too long to solve the above problem, it would be hard to handle.
Enomoto (U.S. Pat. No. 6,840,934) patented a laser treatment apparatus that can extend the treatment reach distance by having the light tubes be extended in length thus allowing the handpiece to reach further away from the apparatus without the need to move the whole unit. At the end of the articulated arm, and connected mechanically to the end of the articulated arm, the laser beam will be guided to a surgical instrument that allows use of the radiation in the laser treatment.
Sharon et al. (U.S. Pat. No. 3,865,113) patented a plurality of surgical scalpels that are used in much different surgical treatment. These scalpels are with fixed optics and they are designed for a free hand surgical treatment.
Zandberg (U.S. Pat. No. 4,228,341) patented a mechanical control apparatus to enable one to manipulate a focused beam in the field of view of a surgical microscope to enable the surgical treatment to be performed using the microscope. In that invention, the mechanical attachment that is mounted mechanically onto the surgical microscope has a mechanical ball mounted drive that tilts a reflecting mirror that causes the manipulation of the laser beam. According with that invention, and as the existing practice, the use of a laser apparatus with a surgical microscope will require the use of an additional instrument, such as the said device.
Similarly, Raif et al. (U.S. Pat. No. 4,597,380) patented an endoscopic attachment to a surgical laser. The attachment is to be used with a surgical laser producing a working laser beam. The coupling device includes a pivotable reflector in the path of the laser beam for reflecting it through the endoscopic tube to the working area at the front end of the tube, and a manipulatable joystick connected to the reflector for manipulating the laser beam to direct it through the endoscopic tube to selected positions in the working area at the front end of the tube. Again, according with that invention, and as existing practice, the use of a laser apparatus with a surgical endoscope will require the use of an additional instrument, such as in that invention.
Zair (U.S. Pat. No. 5,814,042) patented an apparatus for applying a laser beam to a working surface, by displacing the laser beam to trace a plurality of circular scans over the working surface; and continuously varying the diameters of the circular scans at a rate to produce a substantially homogenous distribution of the laser energy over the working surface. According to that invention, an external instrument is connected to the end of the arm, that instrument is electrically powered, using scanning mirrors that deflect the laser beam in a particular circular pattern. Similarly, Assa et at. (U.S. Pat. No. 5,906,609 and U.S. Pat. No. 5,938,657) patented a method and apparatuses to deliver focused laser energy to selected area. The method and device have means to focus a laser beam and means to move the laser beam in both X and Y directions to be directed to a selected area within the marked outline. These methods are currently used in many different applications in the cosmetic surgery field. Again, this attachment is connected to the end of the said articulated arm.
Additionally, articulated arm beam delivery is mechanically sensitive to alignment. The system tends from time to time to become misaligned, at which time the system becomes unusable, until a service technician can repair the system by realigning all the joints.